Objective To investigate pain heterogeneity in transfusion with different gestures in order to find the best gesture.Methods 80 cases were randomly selected and transfused in the back of the hand with three infusion gestures,which including horizontally laid hand with extended fingers for 20 min as control,horizontally laid hand with relaxed fist for 20 min and horizontally laid hand with fist for 20 min in time sequence.Mark-Gail method was used to assess the pain grade.Results Pain was enhanced in horizontally laid hand with relaxed fist group and horizontally laid hand with fist group when comparing with horizontally laid hand with extended fingers group.And pain was more stronger in horizontally laid hand with fist group than that of horizontally laid hand with relaxed fist group.Conclusions Transfusion with horizontally laid hand combining with extended fingers implicated minimum pain and was the best gesture.Horizontally laid hand with fist flat finger displayed the strongest pain and should be banned.

Objective: To investigate the effects of the exogenous testosterone propionate on apoptosis of rat germ cells and the mechanisms thereof. Methods: Thirty 35-day-old male SD rats were randomly divided into experimental group and the control group. The rats in experimental group were injected (i.m.) testosterone propionate and the control group with an equal volume of saline. By using terminal deoxynueleotidy transferase nediated dUTP nick-end labeling (TUNEL), flow cytometry (FCM), radioimmunoassay (RIA) and electron microscopy, the quantity and quality of apoptosis of germ cells were evaluated. Results:(1) Compared with the control, the apoptotic number of rat germ cells was increased in the experimental group, especially the primary spermatocyte. The apoptotie rate was 11.3% detected by FCM in experimental group,while 3.6% in the control group (P ＜ 0.01). (2) The percentages of 1C were 21.8% in experimental group and 33.8% in control group (P ＜ 0.01).The percentages of 2C were 52.6% in experimental group and 37.1% in control group (P ＜ 0.01). (3) The serum levels of testosterone were (3 486.8±333.3) ng/L in experimental group and (846.9±167.5) ng/L in control group (P ＜ 0.01). The serum levels of follicle-stimulating hormone (FSH) were (2.5±0.8) IU/L in experimental group and (5.2±1.7) IU/L in control group (P ＜0.01). Conclusion: The exogenous testosterone propionate might induce apoptosis of germ cells by retroinhibition of the hypothalamie-pituitary-gonadal axis, thus having contraceptive effects.

Objective To investigate the expression of mRNAs for cholesterol side chain cleavage enzyme (p450 scc), 17?-hydroxylase / C17-20 lyase (P450 C17) and 3?-hydroxysteroid dehydrogenase (3?-HSD) in frontal cortex, amygdala, hippocampus, striatum and midbrain of morphine dependence rats.Methods Twenty-one male SD rats were randomly divided into 3 groups with 7 animals in each group: (1) control group (group C) ; (2) morphine dependence group (group D) and (3) morphine withdrawal group (group W). In group D and W the animals were given intraperitoneally increasing doses of morphine starting from 5 mg?kg-1 to 10, 15, 20, 30, 40 and 50 mg?kg-1 twice a day for 7 days. In group C the animals were given normal saline instead of morphine. In group C and D the animals were decapitated 1 h after last injection. In group W naloxone 2 mg?kg-1 was given 1h after last morphine injection, then the animals were decapitated 30 min after withdrawal symptoms were observed. The brains were immediately removed and the frontal cortex, amygdala, hippocampus, striatum and midbrain were separated. The expression of mRNAs for the three steroidogenic enzymes in the different brain regions of rats were determined by RT-PCR.Results The expression of P450scc mRNA in striatum and 3?-HSD mRNA in amygdala, striatum and frontal cortex decreased in group D compared with group C. The expression of 3?-HSD mRNA increased in morphine withdrawal group compared with group D.Conclusion The gene expression of steroidogenic enzymes decreases in some brain regions of morphine dependence rats, suggesting that endogenous neurosteroids might be involved in morphine dependence.

AIM To investigate if morphine addiction and relapse to morphine-seeking is related to the change in neurosteroid levels in the brain of rats. METHODS Rats were injected ip morphine (5 mg·kg-1·d-1, 18:00-20:00) and trained in conditioned place preference (CPP) box, once daily for 10 d. CPP test was performed 24 h after the last training. After discontinuation of training for 7 d for CPP extinction, then intermittent and inescapable foot-shock (FS, 0.5 mA, 0.5 s on, 40 s off, 15 min) was applied to rats as the priming stimuli for relapse. CPP test was performed 2 h after FS. When CPP test finished, rats were decapitated and the levels of neurosteroids were analyzed using gas chromatography/mass spectrometry. RESULTS CPP was established when rats were injected morphine and trained for 10 d. At the same time, the levels of pregnenolone and allopregnanolone in the brain tissues of rats were significantly increased. When CPP was reinstated in morphine-treated rats by FS-stress after 7 d CPP extinction, the levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate were significantly increased. CONCLUSIONThe development of morphine addiction and relapse may be related to endogenous neurosteroids in rat brain tissues.

Objective To investigate healthy status and disease distribution of couples through analysing the results of pre‐preg‐nancy laboratory examination and to explore high risk factors ,in order to provide scientific references for the realization of eugenics . Methods The routine blood test ,serum markers of hepatitis B ,five items(TORCH) examination ,detection of female vaginal secre‐tions were carried out in 8 313 couples planning pregnancy from 2013 to 2014 ,and the results of pre‐pregnancy health examination were analysed and evaluated .Results The thyroid dysfunction accounted for 17 .43% of all women undergoing examination ,which was the most common disease .Among items carried out in all couples ,thalassemia and positive of hepatitis B surface antigen were the most common ,accounted for 10 .20% and 9 .94% respectively .Conclusion The pre‐pregnancy health examination could screen high risk factors ,which is benefit for guiding eugenics and effectively reducing the birth defects and adverse pregnancy and is a sig‐nificant measure for eugenics .

Objective To explore the different apoptotic gene expressions and apoptotic signaling transduction of human rhabdomyosarcoma (RD) cells infected by enterovirus 71 (EV71) in different stage.Methods The survival of EV71-infected RD cells was observed by trypan blue staining.The apoptotic morphology and rates of RD cells were surveyed and detected by Annexin V-FITC/PI staining and flow cytometry,respectively.PCR array was employed to analyze 88 apoptotic gene expressions from EV71-infected RD cells at 8 h and 20 h postinfection (p.i),respectively.Results After RD cells were infected with EV71 (MOI =5) at 8 h p.i,the viability was significantly decreased.Flow cytometry data demonstrated that the apoptotic rates of EV71-infected RD cells had increased to 18.0％ and 19.1％ at 20 h p.i in early and later stage respectively.RT-PCR array studies revealed significant variations in the expression of apoptotic genes.Among 88 genes,only the expression of IFN-β1 was upregulated 5.22 folds,whereas 47 genes including ACIN1,Akt,Apaf1,caspase and CIDEB were found to be downregulated that were lower than 2 folds at 8 h p.i.However,28 genes including FasL,CD40L,TNF,caspase-10 and caspase-3 were induced more than 2 folds after EV71 infection at 20 h.Conclusion The downregulation of apoptosis-related genes is associated with viral apoptosis-suppressing effect in RD cells in the early stage of EV71 infection.The death receptor signaling pathways including Fas/FasL and TNF/TNFR are activated to induce cell apoptosis in the late stage of EV71 infection.Moreover,host cell can also inhibit apoptosis by regulating signal pathway of CD40/CD40L,NF-κB/RelA and PI3K/Akt activation.

Objective To explore the application effects of Donabedian's structure-process-outcome three-dimension quality assessment model on perioperative blood glucose management among elderly patients with hip fracture. Methods From September 2016 to April 2017, a total of 129 elderly patients with hip fracture of the Third Hospital of Hebei Medical University were numbered according to admission order. From September to December 2016, a total of 62 cases were in control group receiving routine blood glucose management. From January to April 2017, 67 cases were in observation group treated with blood glucose management based on Donabedian's three-dimension quality assessment model. And then, we compared the blood glucose on admission and before discharge, waiting time before surgery, healing time of wound and cases of hypoglycemia. At the same time, we investigated the demands of training content of medical staff (n=133). Results There was no statistical difference in the first blood glucose 24 hours after admission and 2 hours after meal of patients between two groups (P＞0.05). After intervention, the waiting time before surgery, healing time of wound and incidence rate of hypoglycemia in observation group [(3.34±0.88) d, (4.43±1.38) d and (3/67, 4.5%)]were less than those in control group [(4.63±1.41) d, (6.47±2.24) d and (10/62, 16.1%)];the fasting blood glucose and blood glucose 2 hours after meal in observation group [(5.96±1.21), (7.60±0.96) mmol/L] were lower than those in control group [(10.80±1.14), (9.94±1.98) mmol/L]one day before discharge all with significant differences (P＜ 0.05). There was also significant difference in blood glucose 2 hours after meal in observation group before and after intervention (P＜0.05). The demands of training content of medical staff (n=133) included diet management, correct usage of insulin, oral hypoglycemic agents instruction, blood glucose monitoring management;the influencing factors on implementing blood glucose management involved busy work, inconsistent dinner time, insufficient knowledge, and so forth. Conclusions Blood glucose management process based on Donabedian's three-dimension quality assessment model can effectively control perioperative blood glucose among elderly patients with hip fracture, shorten waiting time before surgery as well as healing time of wound and reduce cases of hypoglycemia which makes for overall rehabilitation of patients.

Objective To retrieve,analyse and integrate the best evidences in perioperative fluid management for elderly patients with hip fracture,therefore to provide references for patient care.Methods Following the 6S evidence model,databases and websites were searched to collect the evidences on perioperative fluid management of elderly patients with hip fracture.The searched databases including BMJ Best Practice,UpToDate,AAOS Clinical Practice Guidelines,ASBMR,ANZHFR,ESTES,NICE,SIGN,JBI,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,Wanfang Data,VIP database,CEBM Database,Medive,China Science and Technology Journal Database,SinoMed,and other websites about orthopaedics.The searched literatures included guidelines,clinical decision-making,best practices,expert consensus and systematic reviews.The time span for the published literatures was from the inception of the databases and websites to August 2022.Two researchers independently completed quality evaluations of the retrieved literatures,as well as extraction,assessment and integration of the abstracted evidences.Results A total of 15 articles were included,they were 2 guidelines,3 clinical decision-makings,1 best practice,7 expert consensus,and 2 systematic reviews.Thirty pieces of evidence were summarised from 7 aspects,covering multidisciplinary team collaboration,dynamic assessment and monitoring of fluid status,fluid resuscitation,fluid management before and after the surgery and health education.Conclusions This study summarised the best evidences in perioperative fluid management for elderly patients with hip fracture.The evidences provide an evidence-based solution which will enable the healthcare workers to fully combine the clinical scenarios,evaluate changes in fluid volume status dynamically,develope personalised fluid management strategies and improve patient outcomes.

Objective:To clarify the anti-inflammatory effects and anti-endoplasmic reticulum stress effects of resolvin D2 (RvD2) in viral myocarditis mice and to explore its possible mechanism.Methods:Fifty male BALB/c mice were collected and assigned corresponding numbers. Then 40 male BALB/c mice were selected randomly with 10 mice in each group. They were set as normal control group, RvD2 control group, viral myocarditis group and RvD2 treatment group. Afterwards, mice in the RvD2 control group received continuous intraperitoneal injection of RvD2 for 7 days, while mice in the viral myocarditis group received intraperitoneal injection of Coxsackievirus B3 virus (CVB3) in the purpose of constructing an animal model of viral myocarditis. Then, mice in the RvD2 treatment group were given continuous intraperitoneal injection of RvD2 for 7 days. After these 7 days, the mice of each group were sacrificed and their cardiac tissue and serum samples were taken. The expression levels of serum inflammatory factors including IL-1β and TNF-α were detected by ELISA in each group of mice, and HE staining were used to detect the inflammatory cell infiltration in myocardial tissue of each group. Meanwhile, the expression levels of inflammation-related proteins IL-1β, TNF-α as well as endoplasmic reticulum stress-related proteins like GRP78 and Chop in the myocardial tissue in each group of mice were detected by Western blot experiment. The remaining 10 BALB/c mice were treated with intraperitoneal injection of RvD2 as well as GPR18 protein inhibitors after constructing the animal model of viral myocarditis mentioned above. In the end, the expression levels of GPR18 protein, inflammation-related proteins including IL-1β and TNF-α as well as endoplasmic reticulum stress-related proteins like GRP78 and Chop in the myocardial tissue of each group were detected by Western blot experiments.Results:Compared with the normal control group, the expression levels of inflammatory factors IL-1β and TNF-α in the serum of mice with viral myocarditis were significantly increased, and the degree of infiltration of inflammatory cells in myocardial tissue was also significantly increased. Besides, the expression levels of the inflammation-related proteins IL-1β, TNF-α as well as endoplasmic reticulum stress-related proteins including GRP78 and Chop increased largely. While compared with the viral myocarditis group, the expression levels of serum inflammatory factors IL-1β and TNF-α in the mice of the RvD2 treatment group were significantly reduced and the degree of infiltration of inflammatory cells in the cardiac tissue was significantly reduced. Also, the expression levels of inflammation-related proteins IL-1β and TNF-α as well as endoplasmic reticulum stress-related proteins GRP78 and Chop were significantly reduced. After intraperitoneal injection of RvD2 and GPR18 inhibitor, in the mice treated with viral myocarditis, the expression levels of IL-1β, TNF-α and endoplasmic reticulum stress-related proteins like GRP78 and Chop in myocardial tissue of these mice significantly increased when it came to compare with the RvD2 treatment group, while the expression levels of GPR18 protein were significantly reduced.Conclusions:RvD2 can inhibit the inflammatory response and endoplasmic reticulum stress injury in mice with viral myocarditis by binding to the membrane protein receptor GPR18, thus exerting a protective effect on heart.

Trimethylamine oxide (TMAO) is a product of the metabolism of nutrients such as choline by intestinal microbes and liver enzymes. Recent studies have revealed that TMAO may be essential for occurrence and development of cerebrovascular diseases by disturbing the reverse transport of cholesterol, upregulating expressions of macrophage receptors associated with development of atherosclerosis, synthesis of bile acids, vascular endothelial cell inflammation, platelet aggregation and thrombosis. In this paper, we review recent studies about the production of TMAO, and efficacy of TMAO in occurrence and development of ischemic cerebrovascular diseases. This review will help us to understand TMAO related pathogenesis and pathophysiological process of ischemic cerebrovascular diseases and to identify potential therapeutic targets to facilitate translational research in this field.